Ann Hepatobiliary Pancreat Surg.  2020 Feb;24(1):1-5. 10.14701/ahbps.2020.24.1.1.

Hepatobiliary and pancreatic surgery in the elderly: Current status

Affiliations
  • 1General Surgery Unit, Del Mare Hospital, Naples, Italy. davide.papis@gmail.com
  • 2General Surgery Unit, Santa Maria delle Croci Hospital, Ravenna, Italy.

Abstract

Hepato-pancreatico-biliary (HPB) surgery includes major hepatic resection and pancreatic surgery, both procedures are complex and have a potentially high complication rate. The presence of centers of excellence with a high patients volume has lowered the complication and increased the resection rate. Increased life expectancy and improved general health status have increased the number of elderly patients eligible for major surgery. Since old patients have more co-morbidities and decreased life expectancy, the benefit of these procedures need to be critically evaluated in this group. Analysis of the literature related to this argument demonstrated that pancreatoduodenectomy can be performed safely in selected elderly patients (70 years of age or older), with morbidity and mortality rates comparable those observed in younger patients. This aspect was also confirmed by cost analysis studies that reported similar data in both groups. Similar findings are also reported for major hepatic resection in elderly patients with either hepatocellular carcinoma (HCC), Klatskin tumor or gallbladder carcinoma. More studies are needed regarding the subgroup of very elderly patients (80 years or older). Nevertheless, those elderly patients who will benefit from surgery must be adequatelly selected.

Keyword

Liver; Pancreas; Surgery; Elderly

MeSH Terms

Aged*
Carcinoma, Hepatocellular
Costs and Cost Analysis
Gallbladder
Humans
Klatskin Tumor
Life Expectancy
Liver
Mortality
Pancreas
Pancreaticoduodenectomy
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